Exam 4: Bipolar

Question 1

Manic Episode

Answer 1

dramatic and inappropriate rises and mood out of proportion to the actual happenings in someone’s life; can be happy and euphoric or irritable and angry

Question 2

Hypomanic Episode

Answer 2

less severe symptoms of mania that cause little impairment, changed mood for at least 3 days, uncharaceristic of normal personality, observable by others

Question 3

Diagnosis

Answer 3

3 or more symptoms (4 for irritability) during manic episode: inflated self esteem/grandiosity, decreased need for sleep, more talkatibe, flight of ideas, distractability, increased activity/agitation, excessive involvement in activities; marked impairment in functioning, or necessary hospitaization to self/others

Question 4

Bipolar I

Answer 4

at least 1 manic episode, may be hypomanic, almost always a major depressive episode

Question 5

Bipolar II

Answer 5

at least 1 depressive episode, at least 1 hypomanic episode, no manic episode

Question 6

Cyclothymic Disorder

Answer 6

frequent mild depression and frequent hypomania; symptoms at least half of the time for at least 1 years (adults) or 1 year (children/adolescents)

Question 7

Age of Onset

Answer 7

average adolescence/early adulthood, diagnosis between 15-44
Bipolar I: 18
Bipolar II: 19-22

Question 8

Prevalence: Lifetime Bipolar

Answer 8

up to 4% (less common than depression)

Question 9

Prevalence: Lifetime Cyclothymic

Answer 9

.4-1%

Question 10

Prevalence: 1 yr. Bipolar I

Answer 10

.6%

Question 11

Prevalence: 1 yr. Bipolar II

Answer 11

.8%

Question 12

Gender Patterns

Answer 12

m = f, but first episode is more likely depression in females and mania in males, females more likely to have depressie episodes and cycle more rapidly through episodes

Question 13

Comorbidity (Bipolar I and II)

Answer 13

substance abuse, eating disorders, ADHD, panic disorder, social anxiety, higher suicide rates, bipolar II: BPD

Question 14

Bipolar in Children

Answer 14

often used as catch-all category for aggressive kids (disruptive mood dysregulation disorder has become a more common diagnosis), over-diagnosis caused overmedication with meds not tested in kids

Question 15

Psychodynamic Theory

Answer 15

mania as a defense against depression and low self esteem

Question 16

Biological Theory: Neurotransmitters

Answer 16

norepinephrine/serotonin overactivity or difference in receptors; seems to be associated with less serotonin but neurotransmitter role is unclear and generally unsupported

Question 17

Biological Theory: Sodium Ion Instability and Membrane Permeability

Answer 17

Lithium (blood salt) as major treatment effective in moderating mood swings and regulating bipolar and MDD; theory suggests that Na+ does not properly flow in and out of membrane properly during action potential; now a revised hypothesis including calcium; membrane permeability problems including Protein Kinase C

Question 18

Biological Theory: Genetics

Answer 18

higher heritability in bipolar than depression but does not completely account; twins: MZ 70% DZ 30% (larger gap between MZ and DZ); 25% first degree relatives have mood disorder (usually depression)